Older patients with neurodegenerative disease quite often need surgery for reasons unrelated to their cognitive problems. Both the hospital and surgical environments can be challenging for patients, but with some planning, these difficulties can be minimized. The suggestions that follow are not all inclusive, and we suggest discussing suggestions your physician/s may have prior to any surgical procedure.
The risk of cognitive decline related to surgery and anesthesia continues to be debated in the scientific literature. Some animal studies suggest that anesthesia may worsen the development of the plaques and tangles associated with Alzheimer’s disease while others identify the surgical procedure itself to be a problem by causing inflammation and release of harmful proteins. Others attribute temporary or permanent cognitive changes to the medications used to manage pain or other complications of being hospitalized. Ultimately, although this is a very active area of research, there are no definitive studies in older humans that prove a causative effect on the brain from anesthesia or provide recommendations on specific choices of anesthesia. Despite this, we hope to be able to identify information that may help our patients with cognitive problems evaluate the risk and make informed choices about surgery and anesthesia.
Hospitalization of a patient with dementia is a potentially stressful experience often associated with negative outcomes for both the patient and family. The “Partner With Me” (PWM) project was developed to educate and connect healthcare providers with family caregivers of our patients with memory impairment.